Best reasons to tell suicide to fuck off, oh, and a discourse on the ethics of living with depression

Yeah, this one's a pick-me-up, for sure.

Hanne Blank Boyd wrote a good piece the other day, The Best Reason I Have Ever Found Not To Kill Myself. It’s a righteous rant and a good read. However her reason doesn’t work for me, and of course it won’t work for many people. Each individual is different, and though we can help each other and Blank Boyd’s (thanks, Hanne!) reason will work for some and is therefore worth sharing, it won’t be a useful answer for the majority of us. That realization instantly made me think that we should collect the best reason from as many different people as possible. For that reason, I encourage you to put yours in the comments below. In a while I’ll run an OP with a list of as many “best reasons” as I can find. I expect these reasons to come from you, so if you have ever seriously contemplated suicide, get down in the comments or write your own post somewhere (and link it) telling us what your best reason is or was.

The troublesome bit for me, however, is that my own best reason is … not one I think will be well received. My own best reason concerns the ethics of depression.

Now before we dive in, let me assure you that this will be TMI and CONTENT WARNING and all that, but also that the main reason why I think that my reason won’t be welcome is that most people forget that in the realm of ethics, should implies can. When you forget that, what I am about to say can sound much more like fascist guilt-tripping than helpful advice. Be gentle with yourself when thinking about the ethics of depression that I discuss here. I do not present them to give you another reason to feel angry at or disappointed in yourself.

The second preface statement is that this is not meant to be advice. I think that Boyd intended her piece to be advice, though of the mild “advice if it works for you, but at least consider trying it out” type of advice. Still, she seems to be advocating for her best answer as a good one to be picked up and used by many. I am not at all sure that my best answer can be used by many, much less should. I am only sure that it has worked and continues to work for me, in my unique context, inside my unique brain.

But with those thoughts out of the way, let me begin the ethics portion of this essay with what we all know: depression affects far more than the depressed person. Depressed people: you are loved, however much you might feel that to be impossible. One of the damn troublesome corollaries to that statement, however, is that there are very few situations in which one can affirmatively kill oneself without negatively affecting someone else. Like, seriously negatively affecting them.

This harm-to-others (from potential suicide but also from depressive symptoms themselves) has been used against people with depression in manipulative and unethical ways. That some have used this fact badly, however, does not mean that it is untrue. I have quite a few experiences to back this one up empirically.

My own beloved stepbrother was a gymnast of incredible strength and skill. He was expected to win a national championship on at least one apparatus and very possibly the all-around in his junior year of college. Men gymnasts peak in the mid-20s. so he was only supposed to be better in his senior year, and some of his competition would have graduated. He had every reason to believe that he would be on the US Olympic team in Atlanta in 1996, and had reason to hope he might be good enough for Barcelona in 1992. He suffered a career ending injury and never recovered. It’s actually not uncommon for elite athletes to suffer depression after their careers end. I’ve talked about it before. We need to be better to our athletes to prevent and ameliorate this kind of thing. But if and when we ever do decide to recognize that with the great privilege of elite athletic ability comes a huge and painful let down when that privilege ends, it will be too late for my brother. He shot himself to death. I got word an hour before I was supposed to go to a wedding. It hurt me, but it absolutely crushed my mom and stepdad.

My family is large and complex, and we didn’t do so well at being a good family before I became an adult. Arguably we don’t do a great job now, but we’re better than we were. My mom wasn’t always great at being in my corner during my early years. Part of that was her own upbringing which didn’t prepare her well for parenting, and part was because I was a weird kid, and she just didn’t understand me. But she’s done well by me the last couple decades, and she did give me life. And more important than anything, whether our communication or our relationship or our anything else is going well or poorly, she loves me.

If I killed myself, I would wound my mother deeply. I would hurt her more than my brother did, and that hurt viciously. She’s been particularly keen to help anyone in the family struggling with depression since we lost my brother. She hasn’t neglected me. She hasn’t neglected grandkids. She’s been good and kind and as understanding as she can, and she’s spoken about the issue to others as well, trying to create a better world as best she knows how.

Am I, then, just to stick a knife in that?

I mean, me, sure. Stick a knife in me all day long. I have relentless, disabling, treatment-resistant depression. I don’t value myself. Hell, with my physical disability and resulting pain, you could literally torture me to death and within a month you’d have saved me more physical pain than you caused, and that’s not even considering the constant pain in my psyche.

Let me tell you about that, too. This, though, requires a little more talk about ethics. In most circumstances I cannot ethically talk to others about my depression. Not with friends, not with therapists. Killing myself would cause a great wound to my mother and stepfather, it’s true. But just overhearing conversation about depression can hurt people. Listening to someone you care about speaking of their depression is sometimes incredibly painful. It simply is unethical to talk about things that cause others pain without some compensating reason, some justification, a certainty that the information will come out anyway, or some reasonable hope that the painful conversation will bring some benefit greater than its harms.

For most people with depression, there is an understanding of this. I myself was rather oblivious to it during my teen crisis, but I did listen to others and hear how I had affected them. And I learned. Others do as well, if the depression lasts long enough or recurs. This frequently manifests in a reluctance to speak about it. But it’s not usually an insurmountable reluctance. And it shouldn’t be: there are good reasons to speak about depression, and there are good persons to speak to about your depression. As much as you might despise yourself at times, those people who love you exist, and would rather hear your difficult truths than see depression cut you open, bleed you out, remove you an impossible distance.

The ethics of treatment resistant depression, however, are different. Nothing you do will help me. Nothing you do can help me. And so balancing factors that might come from preventing my death or just feeling satisfied to have helped, those benefits that might offset the harms of inflicting the horror of my psyche on others, they simply do not exist.

I have had truly world class care at times in my life. The interventions were complex, empirically founded, multi-modal and multidisciplinary. I bought in fully. I did everything asked of me, and gave each task my best. And I improved. But to say I improved is to say that I went from thinking hateful, self-aggressive thoughts every minute to every fifth. Tourette’s-like yells of “I hate myself” that I cannot ever seem to fully stop reduced to a few a day. Around the kids I managed to add a syllable, so it sounded to them like I said and intended to say, “I hate my cell phone.” I knew different. My disease knew different.

This is not something that will ever go away. On good days and bad, I will think of killing myself once every few minutes. My disease will drive sharp, hateful thoughts into the middle of my brain no matter how well I try to armour or defend myself. I can be talking to an old friend, eating my favourite food, lying on my back observing a meteor shower; none of it will make a difference. Sometimes multiple times a minute, but at the best of times once every few, my disease will stab me again. And again. And again.

How does it benefit my best friend to know this? How does it benefit you? It doesn’t. It can’t. In the abstract, knowing that depression like this exists. somewhere in the world might do some good. Maybe it encourages you to donate to something, or perform your own original research, or vote to implement and support national health insurance wherever you may be. But it does you no good to know that I am in pain now. Or now. Or now. You don’t need to hear the details of my first suicide attempt or my last. If you don’t care, then it may not harm you, but it doesn’t help you. If you do care about my suffering, telling you those details is only setting you up for failure. Because if you care, you’ll want my suffering to stop. And it won’t. I love you all, but if the best care in the world couldn’t stop this, then you can’t.

This logic, remember, doesn’t work for people who pass in and out of acute crisis. It doesn’t apply to people who can be helped with treatment. The ethics of depression demand that we don’t talk about our trauma carelessly, but in most cases it does serve a purpose. In most cases the ethics of depression would encourage a person to speak, not to be silent. Perhaps it might call for speaking only to specific people, or to one specific person. Perhaps it might call for blurring out some details. But in nearly all cases, the ethics of depression would have us speak.

I can’t do this. This option is not available to me.

It would seem like these circumstances should lead inexorably to killing myself, but they do not. The ethics of speaking depend on whether some benefit, direct or indirect, can be expected or hoped to accrue to the people who might suffer indirect trauma when hearing our pain. But the ethics of killing ourselves are simpler. There are very, very few benefits that could possibly outweigh the harm that killing oneself inflicts on others, and no benefits at all that could outweigh the harms to those who love us most and best.

My best friend, my oldest continuous friend, my parents, a few others: none of them would gain anything that could compensate for the pain of learning that I had killed myself.

And so I persist. I don’t want to. Honestly, I would much prefer death. But I persist. I am not now, nor will I ever be willing to hurt the people who offer me nothing but love. So I persist.

I may consider myself worthless. I may consider myself a terrible person. I may consider my sins unforgivable, even as I know that they pale in comparison to sins that I have forgiven in others.

I honestly don’t have hope I will ever be better. I have quite a lot of evidence that I will never be better. But I could always be worse. I could knowingly inflict avoidable harm on people — good people, bad people, it doesn’t matter to me, though those closest to me are all good ones. That I will not do.

It may not be a very good reason. It may even be a bad reason. It has certainly been wielded callously in others’ hands. But of all the reasons keeping me alive, this is the most important, the most effective. Poor or not, it is the best I have: I will not raise my hand against myself because it would inevitably strike others. I can cry because of it. I can regret it. I can wish the world to stop caring for me, to armour itself against the violence of my future death.

But in the end it remains true. In the end, hurting myself hurts others. And so in the end, I persist.

If you have ever seriously considered killing yourself, please share a comment with your reasons for telling suicide to fuck off. Someday your reason might help another person stick around a few more days, or months, or years. Any solace we can give would be a blessing.